Box breathing: what the evidence says

Box breathing means breathing in, holding, breathing out and holding again for equal counts, usually four seconds each. It slows your breathing, which is the part with solid evidence behind it. Direct research on box breathing itself is thin: in the one randomized trial that tested it, it helped mood and anxiety, but less than cyclic sighing.

Box breathing - in, hold, out, hold, four counts each - is widely taught. What the research actually shows, how to do it, and how it compares.

Beiing evidence map

Evidence: Limited for reducing stress and improving mood

How to do it

1. Breathe in through your nose for a count of 4.
2. Hold gently for 4.
3. Breathe out for 4.
4. Hold for 4, then repeat for a few minutes.
5. If the holds feel uncomfortable, shorten them or drop them.

What the research shows

Box breathing paces you at about four breaths a minute, which falls in the slow-breathing range that reliably calms the body (see slow breathing).

As a named technique it has little dedicated research. In a 2023 randomized trial, a box breathing group (21 people, 5 minutes a day for 28 days) improved in mood and anxiety along with every other group, but cyclic sighing improved positive mood more.

What "Limited" means here: A small number of small or early studies. Promising or plausible, not established. Rated for: Reducing stress and improving mood.

Key studies

• Brief structured respiration practices enhance mood and reduce physiological arousal

  Balban MY, et al. Cell Reports Medicine, 2023 · Randomized controlled trial with a 21-person box breathing arm

  Box breathing improved mood and anxiety, but less than cyclic sighing on positive mood.

• Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis

  Laborde S, et al. Neuroscience and Biobehavioral Reviews, 2022 · Meta-analysis, 223 studies of slow breathing in general

  Slow breathing, the pace box breathing produces, raises heart rate variability.

Safety notes

• Skip or shorten the breath holds if you are pregnant, have a heart or lung condition, or feel lightheaded.

Common questions

Why do people say Navy SEALs use it?

It is widely taught for staying calm under pressure, including in military settings. That popularity is not the same as research evidence; the studied benefit comes mostly from slowing the breath.

Checked against the studies above on October 28, 2026 by Beiing's editorial and research team (writers and researchers, not licensed clinicians). How we review · For clinicians

More from the evidence map

• Slow breathing (about 6 breaths a minute) Moderate
• Cyclic sighing Limited
• 4-7-8 breathing Limited
• Nature sounds Moderate
• Music for stress Strong
• White, pink and brown noise for focus Limited
• White noise for sleep Insufficient
• Binaural beats Limited
• 528 Hz and solfeggio frequencies Insufficient

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Educational content only - not medical advice. In a crisis, call or text 988 (US) or your local emergency number. See crisis resources.